Wednesday, October 7, 2015

Buy-In From Client and Therapist

     When a therapist and a client take on a problem, both parties experience buy-in. I am not sure that this is a term in the vernacular of the field yet, but it should be. Both parties experience varying levels of this state, which to define it, might sound something like: "The idea that a person will get something out of the experience that will benefit them in the long-/short-run . . ." I'm sure there is more to it than that, but that is just off the cuff, as it were.
     As stated, the level of buy-in varies and depends very much on many different factors. Just a few are the client-clinician match, pre-conceived notions of therapy and its uses/structure, how the experience starts, and similarities or differences in communication styles. A client can come into therapy wanting to use the session(s) to complete good work that will change something in his or her life. Similarly, yet completely opposite, a client might enter therapy without their consent. A clinician can have the same bipolar situation going on, one day entering a session with relish and an attitude of "stick-to-it-ness," but show a very different side of themselves later.
     This entry is not about the on-going buy-in of clinician or client, but rather the resolution felt by either party at the end of a span. I did not know the correct word to use, so "span" it is. By this word, I mean to signify the end of a certain issue, whether that be a problem going on in a client's life or the end of therapy with that particular client. Obviously, a client gets resolution during therapy; that is what successful therapy is all about. I would like to look at the theme of resolution at the end of a span on the part of the therapist. Does the therapist need resolution as well? What does therapist resolution mean and look like?
     These are very difficult questions. I would say, even at this early point in my career, that a therapist's resolution is fleeting and transparent when in existence at all. Frequently, the client leaves therapy or moves on to a new subject before therapist resolution can occur. Does this not weigh on the therapist? Does this not decrease future general buy-in for the therapist in the same and different clients? Possibly. Probably. I would say that true resolution - getting past the phenomenological idea that resolution looks different for ever single person, which is true but unhelpful when writing about it - is the knowledge that something was gained by the client due to the time that was spend in the company of the therapist. This is what should be - and I use that word sardonically.
     I think that a therapist frequently wants to get into many issues that a client deems unworthy or not as important as another at a given time. This, I think, can plague the therapist with a case of the "I wish"es, "I should have"es, or give him or her a general sense of not being challenged or stretched in their practice. These are issues that can bring a therapist to his or her knees without good supervision or the help of a therapist's therapist.
     Allow me to talk about these ailments and their specific impacts on the therapist. The first "ailment" is a case of the "I wish"es. Perhaps better said, it is the case of the "If only"s or the "I wish I had"s. When a certain span ends, it is rather simple for a counselor to wonder whether something more should have been done (to be honest, this is the same as the "should"s) to seek a better or different conclusion. The therapist thinks that they did not do a very good job, or could have been better. This can lead to a long-term case of second-guessing, especially when the end to the span was not good for the client and/or ended badly for the therapist.